Severe eczema: how to deal with it


Ashley Hall is seriously ill eczema More than 3 years. When she dried up for the first time, she was only 2 years old, Scaly Appeared on the side of her body.

“My mother noticed that I was scratching it all the time. It’s not like a typical little rash Normally, children…will not disappear. Nothing works-no cream, no lotion. She did everything. So then she knew it was serious. “Said 33-year-old Hall from Livingston, New Jersey.

Hall’s mother took her there Pediatrician.The doctor wiped it off temporarily Infant eczema And opened the frost. But it didn’t work. The rash quickly spread all over her body.This time, I went to the dermatologist’s office to confirm Atopic dermatitis (AD), is a chronic eczema, and Allergy symptoms, This is what Hall has in his lifetime.

What is severe eczema?

Eczema is a type of skin inflammation that can cause a red, itchy, and painful rash. It affects approximately 31 million Americans. But this affects everyone differently.

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For most patients with eczema, the symptoms are mild to moderate and may disappear in time.But for some people, severe dryness Itching, And scratching may be so painful that it may cause the skin to bleed, sores or crumbs may ooze out. If you have severe eczema, you may have persistent attacks on various parts of your body at different times.with skin Frustration can affect your mental health and damage your overall quality of life.

Zelma Chiesa Fuxench, MD, assistant professor of dermatology at the Perelman School of Medicine at the University of Pennsylvania, said that she considered many factors before diagnosing someone with severe eczema.

Chiesa Fuxench said that she asked herself some questions, such as: “What is the level of itching? What effect does it have on lack of sleep? Symptoms of depression or anxiety? Can the patient work at work or at school? Are they going out to enjoy what they are doing? “

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One study found that every 2 participants with severe eczema reported that it affected their lifestyle. Due to the appearance of the skin, they did not engage in social activities and had poor daily activities.

For Hall, when she was a teenager, the “painful rash” made her feel conscious.

“I always wear long sleeves, I always wear pants. I will never wear skirts or skirts-very conscious of it, which again prevents me from really enjoying life,” Hall said.

How to manage eczema triggers

Most correct Causes of eczema Unknown, but experts believe that if your immune system It is activated by both genetic and environmental factors (such as weather, irritants or allergens). The wrong skin barrier may be the culprit. To find the source of the problem, you may need to see a specialist such as a dermatologist, Allergic, Or a pediatrician since childhood.

Currently, there is no known method for treating eczema. However, there are steps you can take to reduce the itching and even avoid the things that might cause dizziness in the first place. Medication is also an option.

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Trigger avoidance:

Dry skin. If your skin loses too much moisture and becomes dry and scaly, it may cause an eczema attack. Especially in winter, this happens when the cool and dry air absorbs moisture from the skin.

“I really emphasize the constant use of moisturizers on the skin. You want to do this at least once a day,” said Chiesa Fuxench.

Irritating. If you come into contact with product ingredients or certain natural substances, it may make your skin itchy and burn. This can include:

  • Certain metals, such as nickel.
  • Washing powder, chemical detergent and soap.
  • Some fabrics, such as wool and polyester.
  • Cigarette smoke.
  • Perfume and fragrance.
  • Dyes and tattoo inks.

Hall said that the salty water feels good to her skin, but spending time in the swimming pool is not an option for her.

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“it [eczema] It will break out completely because the chlorine is inconsistent with my skin. “Hall said.

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Sweat and heat. Your sweat contains trace amounts of certain metals, such as zinc, iron, nickel, and copper. This can irritate your eczema and make it worse in hot spots such as the elbows, back of the knees, or neck that sweats frequently. Although it is impossible to completely avoid sweating, if you do, try to rinse it with fresh water and change to clean clothes.

food allergy. Common foods that may make your eczema symptoms worse are eggs, milk, and peanuts. Approximately 20% to 40% of children with severe eczema usually have food allergies. If you feel that certain foods will make your skin worse, consult a doctor.

asthma or fever. Experts know that for some people, it is common for hay fever or asthma to coexist or ignite with atopic dermatitis. Experts don’t know why.If you are right pollen Or animal dander, please limit exposure.If you are not sure what caused the allergy, please contact allergy Experts in testing and diagnosis.

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pressure. If you feel stressed, eczema may get worse. Experts don’t fully know why.

Since the diagnosis, Hall said that managing the disease is a trial-and-error process. “In the 80s and 90s, there was not much information about it.” But now, in her 30s, she says she has more control over the health of her skin.

“I know some of my triggers, sometimes I don’t know, because it’s a bit confusing, but in fact I don’t go to the dermatologist or doctor very much… [be]Because I feel I have reached a place where I can manage,” Hall said.

Chiesa Fuxench said that she tried to look through the patient’s skin care procedures to understand “what can they do? [at home] In terms of changing their habits to manage their situation. “

However, if home remedies don’t work, your Eczema symptoms Not controlled, please try:

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Local treatment. Your doctor may prescribe over-the-counter ointments or creams that are applied directly to your skin like corticosteroids. If your eczema is mild to moderate, your doctor may prescribe crisaborole (Eucrisa).It works by stopping the substances in your body that cause the following diseases inflammation.

You need to use these medicines exactly as prescribed by your doctor. Excessive use may cause side effects and cause thinning of the skin.In some cases, your doctor may give you stronger creams, such as Pimecrolimus (Eridel) Or Tacrolimus (Subject headings) To reduce inflammation, itching and the need to use steroids.

oral prescription. If severe eczema makes you prone to sores, which may cause infection, the doctor may give you oral Antibiotics It resists bacteria that may enter through a broken skin barrier in a short time.

If there is too much inflammation, you may need to take oral corticosteroids such as prednisone. This is a very strong drug and should not be taken for a long time. It may have serious side effects. Take exactly as directed by your doctor.

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Phototherapy. If topical treatment does not work for you, your doctor may recommend light therapy. Your skin is exposed to a controlled amount of natural sunlight for a certain amount of time. You may also be exposed to other forms of light, such as artificial ultraviolet A (UVA) and narrow-band ultraviolet B (UVB). You can do this treatment with or without drugs.

Light therapy increases your chances skin cancer And may cause premature skin aging. Ask your doctor if this is suitable for your treatment.

If none of these therapies are suitable for you, the FDA has approved a new drug dupilumab for moderate to severe eczema (Dupicnt). Your doctor will have to write a prescription. You can take your own shots at home.

If itching and scaly dry patches affect your self-image or Mental Health, Talk to a therapist or counselor. If the itching disrupts your sleep or develops a habit, you can try relaxation techniques or change your behavior.

Break the itching-cycle from scratch

According to Chiesa Fuxench, there is a saying in the field of dermatology: “We say,’The rash is itchy.'” Basically, this means that the more times you scratch the rash, the more likely it is to become inflamed, and come back Sometimes it becomes more aggressive, red, swollen and painful. It creates an insurmountable “itch cycle”.

In some severe cases, intense itching and scratching may irritate the nerve endings on the skin and make it thick and leathery. The affected area on the skin may darken, and there are obvious lines at the scratches. This is a skin disease called neurodermatitis. If the itch improves, your skin may return to health.

To relieve itching, you can:

  • Moisturize as much as possible.
  • Use creams that contain ceramide, a fat usually found on the skin, to strengthen the skin barrier.
  • Use a low pH skin cleanser.
  • Apply cold compresses.
  • Pinch and pat the itchy part of the skin.
  • Add to Apple cider vinegar Take a bath
  • Soak in baking soda Or oatmeal.
  • Avoid contact with anything that will irritate bare skin. Don’t sit on grass, plastic chairs, rough carpet or furniture. Wear clothes made of soft, breathable natural fibers near the skin.
  • Wrap the itchy skin with wet paper.
  • try acupuncture.

If you just can’t control itching and scratching, please develop one Skin infections From it, or find it difficult go to bed, Consult a dermatologist. They can guide you to the treatment that best suits your needs.

Get your skin back on track after setbacks

After all, treatment and home remedies are not foolproof. According to Chiesa Fuxench, they may not all work for severe eczema, or you may need multiple types of treatment at the same time.

But when dealing with eczema frustration, Hall said it’s about knowing what you can control and trying to be prepared. “I would say that I can’t control the weather. But I do know if I am traveling, and I will get the so-called “eczema emergency kit.”

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For Hall, when she stays in a hotel or with friends or family, it is very important to pack “fragrance-free” products and even bring her own sheets to avoid fire. However, even if Hall stays away from most activities that can cause eczema, although she knows the consequences, she sometimes makes herself happy.

Hall said: “This is a moment, worth it, you just have to do it.”

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“You really need to clearly establish a basic skin care plan. Usually, I am talking about basic and simple, because we really don’t want patients to bear too much treatment costs.

Ultimately, if you suffer from eczema throughout your life, Chiesa Fuxench points out that it’s important to be like other chronic diseases diabetes or hypertension, You will have to maintain treatment at all times.

Chiesa Fuxench said: “We need to think about how to best treat these patients from a long-term perspective.” “The goal is [them] Very happy and able to get through the day of lies without having to think about having to go back to see a dermatologist. “


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